1.
A non-invasive mechanical procedure that delivers a shock wave to areas of the stone to
disintegrate it.
Answer: Extracorporeal Shock Wave Lithotripsy
2. The most common and serious complication of Peritoneal Dialysis.
Answer: Peritonitis
3. What causative agent is commonly associated with acute glomerulonephritis in children?
Answer: Group A Streptococcus
4. A term coined for inflammation of the kidneys and renal pelvis.
Answer: Pyelonephritis
5. Considered first-line medications for urge incontinence.
Answer: Anticholinergic Agents
6. What is the recommended angle for holding the penis during catheterization?
Answer: 60°-90°
7. What is the normal urine specific gravity?
Answer: 1.010-1.025
8. What respiratory pattern might be observed in a chronic kidney disease (CKD) patient
experiencing metabolic acidosis?
Answer: Kussmaul Respiration
9. What is the primary cause of metabolic acidosis in the oliguric phase of Acute Kidney
Injury (AKI)?
Answer: Reduced excretion of daily metabolic load acid-type substances
10. Performed to determine the causative organism so that appropriate antimicrobial agents
can be prescribed.
Answer: Culture and Sensitivity test
11. Infections involving the kidneys (renal parenchyma), renal pelvis, and ureters are referred
to as upper UTIs or _________________.
Answer: Pyelonephritis
12. A test that measures glomerular filtration rate (GFR) and is good approximation of renal
function.
Answer: Creatinine Clearance
13. An involuntary urination, especially at night, also known as bedwetting.
Answer: Nocturnal Enuresis
14. A major clinical manifestation in Nephrotic Syndrome.
Answer: Edema
15. Described as sudden inflammation of the kidneys.
Answer: Acute Nephritis
II.
1. Which of the following strategies may help manage sexual problems in clients with
chronic renal failure?
a) Engaging in regular physical activity
b) Exploring alternative sexual activities that are comfortable and enjoyable
c) Ignoring sexual concerns and focusing solely on medical treatment
d) Avoiding discussing sexual issues with partners
2. A patient with stage 4 CKD asked what type of diet he should follow. You explain the
patient should follow a:
a) Low protein, low sodium, low potassium, low phosphate diet
b) High protein, low sodium, low potassium, high phosphate diet
c) Low protein, high sodium, high potassium, high phosphate diet
d) Low protein, low sodium, low potassium, high phosphate diet
3. Which of the following is a potential complication of the oliguric phase in acute renal
failure?
a) Metabolic alkalosis
b) Decreased blood pressure
c) Pulmonary congestion
d) Decreased level of serum potassium
4. What is a common nursing intervention during hemodialysis therapy to prevent
complications related to fluid removal?
a) Monitoring the patient's blood pressure
b) Administering intravenous fluids
c) Encouraging the patient to eat high-sodium foods
d) Keep the client NPO
5. What is one potential cause of nausea in clients with chronic renal failure?
a) Decreased blood pressure
b) Increased kidney function
c) Low blood glucose levels
d) Elevated blood levels of urea and creatinine
21. What is the recommended technique in obtaining a clean-catch urine culture collection?
a) Provide patient with a sterile urine collection cup so that the client can completely
empty her bladder directly into the specimen cup
b) Use a disinfectant spray directly on the genital area
c) You have to insert a catheter to the client to get the urine specimen
d) Instruct a client to cleanse her labia, void into the toilet, and then into the specimen
cup
22. Which of the following symptoms is NOT typically associated with disequilibrium
syndrome?
a) Nausea and vomiting
b) Confusion
c) Headache
d) Elevated blood pressure
23. What is the ECG finding commonly associated with severe hyperkalemia in acute renal
failure?
a) Widened QRS complex
b) Peaked T waves
c) Prolonged QT interval
d) ST segment depression
24. Which of the following is a common symptom of acute renal failure?
a) Oliguria
b) Polyuria
c) Anuria
d) Dysuria
25. A patient is scheduled for a test with contrast to determine kidney function. What
statement made by the patient should the nurse inform healthcare provider about prior to
testing?
a) “I don’t like needles”
b) “I am allergic to shrimp”
c) “I take medication to help me sleep at night”
d) “I have a test similar to this one in the past”
26. After an intravenous pyelogram (IVP), what is advised to help flush out the contrast agent
from the body?
a) Advised patient to increase physical activity
b) Advised patient to maintain complete bed rest
c) Inform patient that laxative is given
d) Advised patient to drink plenty of fluids
27. What is the primary goal of treatment for patients experiencing severe flank pain due to
renal calculi?
a) Increase fluid intake to dissolve the stone
b) Induce vomiting to expel the kidney stone
c) Relieve pain and discomfort
d) Administer antibiotics to prevent infection
28. What is hyperacute rejection in the context of kidney transplantation?
a) Rejection occurring within the first 24 hours after transplantation
b) Rejection occurring within the first week after transplantation
c) Rejection occurring within the first month after transplantation
d) Rejection occurring after one year post-transplantation
29. What is the recommended approach for women prone to recurrent UTIs related to sexual
activity?
a) Avoiding sexual intercourse altogether
b) Using condoms coated with spermicide
c) Urinating before and after sexual activity
d) Engaging in sexual activity only during certain phases of the menstrual cycle
30. What is the correct technique for performing perineal care in patients with indwelling
catheters?
a) Wiping from back to front to avoid contamination
b) Using harsh scrubbing motions to remove debris
c) Cleaning the perineal area with soap and water or cleansing wipes
d) Rinsing the perineal area with alcohol-based solutions
31. Which of the following laboratory markers may indicate improvement during the recovery
phase of Acute Kidney Injury (AKI)?
a) Elevated serum creatinine levels
b) Elevated blood urea nitrogen (BUN) levels
c) Decreased serum creatinine levels
d) Decreased hemoglobin levels
32. What is the significance of a urine specific gravity of 1.010 or lower in Acute Kidney
Injury (AKI)?
a) Indicates normal kidney function
b) Indicates tubular damage
c) Indicates glomerular damage
d) Indicates urinary tract infection
33. What is one of the primary risk factors for developing kidney stones?
a) Low fluid intake
b) High dietary fiber intake
c) Regular physical exercise
d) Normal body weight
34. Which of the following is a common trigger for the formation of immune complexes in
Glomerulonephritis?
a) Hypertension
b) Diabetes mellitus
c) Infections, such as streptococcal infection
d) Excessive alcohol consumption
35. Hypertension is present in a patient whose renal artery blockage results in renal ischemia.
What is one possible cause of the high blood pressure?
a) Increased ADH secretion
b) Increased renin release
c) Increased synthesis and release of prostaglandins
d) Decreased aldosterone secretion
36. In which clinical manifestations would the increased release of erythropoietin be
expected?
a) Fluid overload
b) Hypoxemia
c) Hypotension
d) Hyperkalemia
37. Which volume of urine in the bladder would cause discomfort and require urinary
catheterization?
a) 1500 mL
b) 1200 mL
c) 500 mL
d) 250 mL
38. A 78-year-old man approaches the nurse, asking her why he needs to urinate so frequently
at night. You are correct if you state that the potential cause of his nocturia is which of the
following?
a) Decreased renal mass
b) Decreased detrusor muscle tone
c) Decreased ability to conserve sodium
d) Decreased ability to concentrate urine
39. Which among the statements below is correct in relation to the physical assessment of
genitourinary system?
a) Auscultates the lower abdominal quadrants for fluid sounds
b) Palpates an empty bladder at the level of the symphysis pubis
c) Percusses the kidney with a firm blow at the posterior costovertebral angle
d) Positions the patient prone to palpate the kidneys with a posterior approach
40. The patient's urinary retention was noted by the doctor. When the significant other asks
what it is, you are correct when you say which of the following statements?
a) Inability to void
b) No urine formation
c) Large amount of urine output
d) Increased incidence of urination
III. MODIFIED TRUE or FALSE. For each statement, indicate whether it is TRUE or
FALSE. If the statement is false, provide the correct answer.
41. Bathing in the tub is of the ways in preventing UTI.
Answer: False, Increase fluid intake
42. Pain or burning sensation during urination is a typical symptom of acute cystitis.
Answer: True
43. Oliguria is defined as a urine output of less than 400 milliliters per day.
Answer: True
44. Saline enema solution is commonly used before a kidney, ureter and bladder (KUB)
radiograph.
Answer: False, lower GI radiography
45. Urge incontinence occurs due to involuntary loss of urine through an intact urethra as a
result of exertion, sneezing, coughing, or changing position.
Answer: False, Stress Incontinence
46. Glomerular Filtration Rate (GFR) is a measure of the rate at which blood is filtered by the
kidneys per unit of time.
Answer: True
47. Muscle weakness and abdominal cramping typically resolve spontaneously without
intervention in the oliguric phase of Acute Kidney Injury (AKI).
Answer: False, Resolve with interventions
48. Intravenous (IV) fluid resuscitation and administration of diuretic (furosemide) are
contraindicated in dehydrated AKI patients during injury stage.
Answer: True
49. Transfusion-related complications can lead to systemic inflammation resulting to Acute
tubular necrosis (ATN).
Answer: True
50. UTIs are more common in elderly women due to changes in pelvic floor muscle tone and
bladder function.
Answer: True
IV. Matching Type.
Urine Color Possible Causes
F 51. Brown to black a. Pyuria
E 52. Pink to red b. Concentrated urine due to
B 53. Orange to amber dehydration
C 54. Colorless to pale yellow c. Excess fluid intake
A 55. Yellow to milky white d. Multiple vitamins preparation
D 56. Bright yellow e. Hemoglobin breakdown
f. Intake of medication such as
nitrofurantoin
V. Enumeration
57-60 Enumerate the first-line antibiotic for uncomplicated UTIs.
a) Cefadroxil
b) Co-trimoxazole
c) Nitrofurantoin
d) Fostomycin
61-68 Enumerate the clinical manifestations of hypocalcemia in patients with kidney disorders:
a) Abdominal and muscle cramps.
b) ECG changes.
c) Stridor.
d) Carbopedal spasm.
e) Hyperactive reflexes.
f) Tetany.
g) Positive Chvostek or Trousseau sign.
h) Tingling of fingers and around mouth.
69-70 Enumerate the general management strategies for hypocalcemia in patients with
kidney disorders:
a) Diet.
b) Oral or parenteral calcium salt replacement.
71-76 Enumerate the clinical manifestations of hyperkalemia in patients with kidney disorders:
a) Diarrhea.
b) Colic.
c) Nausea.
d) Irritability.
e) Muscle weaknesess.
f) ECG changes.
77-83 Enumerate the general management strategies for hyperkalemia in patients with kidney
disorders:
c) Dietary restriction.
d) Diuretics.
e) IV glucose.
f) Insulin and Sodium Carbonate.
g) Cation-exchange resin.
h) Calcium gluconate.
i) Dialysis.
VI. Essay
84. Why is dialysis solution warmed before use in peritoneal dialysis?
Answer: The dialysate is warmed to body temperature to prevent patient discomfort and
abdominal pain and to dilate the vessels of the peritoneum to increase urea clearance.
85. What is the mechanism of action of sodium polystyrene sulfonate (Kayexalate)?
Answer: Kayexalate contains sodium ions bound to a resin. When administered orally or
rectally, the resin reaches the large intestine. In the intestine, the resin releases sodium
ions and binds to potassium ions present in the gut lumen. The resin, now bound to
potassium, is not absorbed by the body and is eliminated with the stool, effectively
removing the excess potassium from the body. As the resin binds potassium, it releases
sodium ions into the body. This can lead to potential side effects, such as sodium
retention and edema, especially in individuals with pre-existing conditions like heart
failure or hypertension.
86-90 How does edema play in nephrotic syndrome?
Answer: In nephrotic syndrome, damage to the glomeruli allows albumin to leak into
the urine(proteinuria), leading to low albumin levels in the blood. With less albumin in
the bloodstream, the oncotic pressure within the blood vessels decreases. This pressure
normally opposes the hydrostatic pressure that pushes fluid out of the vessels and into
the surrounding tissues. These pressures favors fluid movement out of the blood vessels
and into the interstitial space, leading to edema.The kidneys, in response to the
decreased blood volume caused by fluid leakage, activate the
renin-angiotensin-aldosterone system (RAAS). This system promotes sodium and water
reabsorption in the kidneys, further contributing to fluid retention and edema.
